Wellness Library

Company America is increasingly investing in employee wellness because it is good business.  In order to meet productiveness demands, organizations must rely on a healthy, constructive workforce to succeed in the highly competitive global marketplace.  Over a hundred research studies in both corporate and governmental settings have documented the economic advantages of Workplace Wellness Programs, including reduced absenteeism, reduced injuries and workman’s compensation costs, reduced health care costs, reduced employee turnover, as well as increased productiveness, greater worker satisfaction, and improved morale.1-10  

The more recent literature reflects improvements in wellness programming along with greater return on investment.  In general, the more focused and intensive the program, the greater advance realized.  To enhance their effectiveness federal government Employee Wellness Programs may be able to incorporate some of the features described.  Employee wellness programs established to have beneficial returns on investment often include the following features:

1.   Health and productiveness management model
Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical activity, excess weight, unhealthy diet, high cholesterol, high Blood Pressure, stress, depression, and so on.  High-risk workers are specifically targeted for intervention, even though the most thriving programs also direct efforts towards healthy workers in order to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.  

2.   Health risk appraisal
Use of a computerized health risk appraisal (HRA) instrument with individualized feedback and recommendations is almost universal in efficacious programs.  Employees take the questionnaire annually in numerous cases.  The HRA serves to increase awareness, support direction, and excite individuals to improve specific behaviors.  In some cases, the personalized report is directly linked to appropriate resources related to identified risks.  Research indicates that the use of an HRA is effective if it is followed by some kind of educational or therapeutic intervention for identified risks.  It frequently serves as the entry point into wellness programs.

3.   Biometric Testing
Many programs combine the outcome of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI), Blood Pressure, blood lipids, fasting glucose, and assorted other metrics.  Combining the results of the HRA with biological measures results in a more accurate risk profile.   Computerized health risk appraisals frequently incorporate biometric data in their risk analysis.

4.   Incentives
staff members are frequently given monetary or other valuable rewards for completing an HRA, participation in a program or class, specific accomplishments such as stopping smoking, losing weight, or exercising, and for maintaining healthy status and/or behaviors.  In numerous cases the monetary rewards and incentives are associated with reductions in healthcare insurance premiums.  Some programs use disincentives as well as rewards and incentives, such as charging staff members who use tobacco higher rates for their healthcare insurance contribution.

5.   High participation rates
Effective programs use incentives to drive participation rates up.  They also market their programs extensively, and may use contest or challenge strategies to heighten enthusiasm and encourage participation.

6.   Wellness coaching
staff members with identified risks or desire to improve their health habits may be periodically coached via phone by trained health coaches.  Health & Wellness Coaching helps staff members set and achieve realistic lifestyle-related goals/objectives including those addressing stress, work life balance, smoking, weight, physical exercise, and various behavior modifications.  Three or more sessions are generally provided.  In some intensive programs, the coaching extends to actual disease management intervention for staff members with identified high-risk diseases.

7.   Multiple formats
Programs may offer wellness content in internet based, paper, and seminar formats to support stimulating variety and alternatives in order to accommodate the needs of all workers.  In addition to onsite physical exercise and healthy eating activities, on-line programs, e-mail reminders and notices, printed newsletters and materials, and corporation seminars are common dissemination strategies.

8.   Senior Leadership reinforcement
Enthusiastic and frequent endorsement by senior staff is critical to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.

9.   Frequent contact
Effective programs have successive contact of some sort with every employee.  This may be through marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, employee meeting presentations, discussion in new employee orientation, supervisory sessions, etc.   The key is to enhance employee awareness of health and wellness opportunities and reinforce the corporate emphasis on wellness through successive and multiple “touches”.

10.   Open enrollment
To promote high participation rates workers must have simple access to the wellness programs and activities.  Open and uncomplicated enrollment processes achieve this.  Some businesses automatically enroll all workers and then allow those who do not wish to participate to “opt-out”.  This practice has been determined to boost enrollment rates in some settings.

11.   Family involvement
Many programs promote spouses and other family members to take part in the organization wellness activities and to adopt a healthy lifestyle along with the designated employee.  It is far easier for the employee to have a healthy lifestyle if his/her family does so as well.

12.   Smoking cessation
Because smoking and other tobacco use is the number one threat to health it is critical to offer employees effective and convenient assistance with stopping.  Access to smoking cessation pharmaceuticals is frequently part of such programs.  In-house programs offer the most convenient access to these services, even though on-line or phone-based programs may be available as well.  

13.   Exercise
Regular physical exercise is a core component of every wellness program.  Staff Members must be strongly encouraged to engage in regular physical exercise.  Most programs provide either periodic or continuous worksite opportunities, and some locations have worksite gyms, swimming pools, walking trails, etc.  Discounted or paid memberships to neighborhood exercise facilities is a common alternative to worksite facilities.

14.   Weight management
Because obesity is a major threat to health it is imperative that programs offer effective assistance with weight control.  Robust encouragement from senior staff to shed excess weight is important.  Web-based programs, workplace programs, or discounted access to weight control programs in the neighborhood may all be available.  Long-term follow-up is critical for maintenance of weight loss.

15.   Stress management
Workplace stress is perhaps the most common criticism among workers and a major contributor to absenteeism, presenteeism (reduced productivity), and low morale.  Almost all successful wellness programs offer assistance with personal and workplace stress.  Some programs refer workers to outside resources for more genuine conditions like depression and anxiety disorders, but most offer web-based or frequent onsite general stress reduction programs.  Some businesses endeavor to structure the work environment to minimize stress, both physically and operationally.

16.   Health screenings/immunizations
employees are actively encouraged to complete recommended healthcare screenings for Blood Pressure, cholesterol, BMI, colorectal and breast cancer, and others.  Annual influenza immunizations are also encouraged.  Some sites provide these services at the worksite.  Incentives are often awarded for completion of these screenings/immunizations.

17.   On-Site healthcare
Actual provision of onsite primary care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for employees has stimulated this trend.  Some companies have found that it is less expensive to provide primary care services themselves than to fund those services through medical insurance.  Onsite care also reduces the amount of time employees would otherwise spend away from the workplace getting such services.

References

1.   Aldana, Steven G.  (2001)   Financial Impact of Worksite Wellness Programs:  A Comprehensive Review of the Literature.   Am J Health Promotion 15(5):296-320.
2.   Chapman, Larry.  (1998)   The Role of Incentives in Health Promotion.  The Art of Health Promotion  2(3):1-8.
3.   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion:  Is it Really As Important as We Think?  The Art of Health Promotion  7(2):1-12.
4.   Chapman, Larry.  (2005)   Meta-Assessment of Worksite Health Promotion Programs Economic Return Studies: 2005 Update.  The Art of Health Promotion, July/August, 1-15.
5.   Chapman, Larry.   (2006)   Employee Participation in Corporate Wellness Programs and Corporate Wellness Programs:  How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6):  431-432.
6.   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   The Role of Health and Wellness Coaching in Worksite Health Promotion Programs.   The Art of Health Promotion, July/August, 1-12.
7.   Chapman, Larry.  (2007)   Proof Positive:  An Analysis of the cost-Effectiveness of Job Site Wellness.  Northwest Health Management Publishing, Seattle, WA.
8.   Chapman, Larry.  (2007)   An In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
9.   Edington, Dee.   (2001)   Emerging Research:  A View from One Research Center.  American Journal of Health Promotion 15(5): 341-349.
10.   Edington, Dee W.  (2007)   Health Management as a Serious Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
11.   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Work Productivity.   Journal of Occupational and Environmental Medicine, 46(7): 746-754.
12.   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease Management Programs at the Worksite: Update VI 2000-2004.  JOEM 47(10)1051-1058.
13.   DeVol, Ross, Bedroussian, Armen, et. al.  (2007)  An Unhealthy America:  The Economic Burden of Chronic Disease.  Report released by the Milken Institute.   www.milkeninstitute.org.
14.   Partnership for Prevention.  (2008) Investing in Health:  Proven Health Promotion Practices for Workplaces.   http://www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

Tags: Corporate Wellness, health, medical, Wellness Library

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